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CompletedNCT03280537POLYP 2Updated Mar 23, 2020Results posted

A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitus With Nasal Polyps

A Phase 3 interventional study of Omalizumab and Placebo in Nasal Polyps and Chronic Rhinosinusitis, sponsored by Hoffmann-La Roche. Completed at 45 sites in 10 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2020-03-23.

Sponsored by Hoffmann-La Roche · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
127
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The purpose of this study is to determine the efficacy and safety of omalizumab compared with placebo in adult patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who have had an inadequate response to standard-of-care treatments.

Study GA39688 (POLYP 1; NCT03280550) was another Phase III study by the Sponsor with identical objectives and design and was run in parallel with this study.

02

Conditions studied

  • Nasal Polyps
  • Chronic Rhinosinusitis

Browse trials for

03

In context

Nasal Polyps

236 studies on the registry are indexed under Nasal Polyps; 68 are open to participants now.

This study's enrollment of 127 is above the median of 60 across 181 interventional studies indexed under Nasal Polyps.

Browse Nasal Polyps studies →

Lead sponsor

Hoffmann-La Roche is the lead sponsor of 2,101 studies on the registry; 87 are open to participants now.

Of its 330 completed or terminated interventional studies of FDA-regulated products, 248 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 18-75 years, inclusive, at time of signing Form.
  • Ability to comply with the study protocol, in the investigator's judgment.
  • Nasal polyp score (NPS) >= 5, with a unilateral score of >= 2 for each nostril, at screening (Day -35), and on Day -7.
  • Sino-Nasal Outcome Test-22 (SNOT-22) score >=20 at screening (Day -35) and at randomization (Day 1).
  • Treatment with at least nasal mometasone 200 micro gram per day, or equivalent daily dosing of nasal (CS), for at least 4 weeks before screening (Day -35).
  • Treatment with nasal mometasone 200 micro gram twice a day (BID) (or once a day [QD] if intolerant to twice daily) during the run-in period with an adherence rate of at least 70%.
  • Presence of nasal blockage/congestion with NCS >=2 (1-week recall) at Day -35 and an average of the daily NCS score over the 7 days prior to randomization of NCS >1 with at least one of the following symptoms prior to screening: nasal discharge (anterior/posterior nasal drip) and/or reduction or loss of smell.
  • Eligibility per the study drug dosing table
  • Willingness to maintain all background medications stable for the duration of the treatment and follow-up periods.
  • Willingness and ability to use electronic device to enter study-related information in electronic devices (electronic diary [eDiary]/electronic tablet [eTablet]).
  • Demonstration of at least 70% adherence to eDiary daily symptom assessment during run in period, with fully completed entries on at least 4 days in the week prior to randomization.
  • For women of : agreement to remain abstinent (refrain from heterosexual intercourse) or use acceptable methods during the treatment period and for 60 days after the last dose of study drug.

Exclusion criteria

Exclusion Criteria:

  • Known history of anaphylaxis/ to omalizumab.
  • Treatment with drugs within 12 weeks or 5 half-lives (whichever is longer) prior to screening (Day -35).
  • Treatment with monoclonal antibodies (e.g., omalizumab, mepolizumab) for 6 months prior to screening (Day -35).
  • Current treatment with leukotriene antagonists/modifiers, unless participant has been on stable dosing of such medication for at least 1 month prior to screening (Day -35).
  • Treatment with non- within 2 months or 5 half-lives, whichever is longer, prior to screening (Day -35).
  • Treatment with systemic corticosteroids, except when used as treatment for nasal polyposis, within 2 months prior to screening (Day -35).
  • Usage of systemic CS during the run-in period. Participants requiring systemic CS during run-in may be rescreened after completing systemic CS.
  • Treatment with intranasal CS drops or CS administering devices (e.g., OptiNose device or stents) within 1 month prior to screening (Day -35) or during the run-in period.
  • History of nasal surgery (including polypectomy) within 6 months prior to screening.
  • History of sinus or nasal surgery modifying the structure of the nose such that assessment of NPS is not possible.
  • Uncontrolled epistaxis requiring surgical or procedural intervention, including nasal packing, within 2 months prior to screening.
  • Known or suspected diagnosis of cystic fibrosis, primary ciliary dyskinesia (e.g., Kartagener syndrome) or other dyskinetic ciliary syndromes, hypogammaglobulinemia or other immune deficiency syndrome, chronic granulomatous disease and granulomatous vasculitis, granulomatosis with polyangiitis (e.g., Wegener's Granulomatosis), or eosinophilic granulomatous with polyangiitis (EGPA) (e.g., Churg-Strauss syndrome).
  • Presence of antrochoanal polyps.
  • Concomitant conditions that interfere with evaluation of primary endpoint:

    • Nasal septal deviation occluding one or both nostrils.
    • Ongoing rhinitis medicamentosa.
    • Acute sinusitis, nasal infection, or upper respiratory infection during the run-in period.
    • Known or suspected invasive or expansive fungal rhinosinusitis.
  • Known infection at screening.
  • Known acute and chronic infections with virus (HCV) and virus (HBV) at screening.
  • History of myocardial infarction, unstable angina, cerebrovascular accident, or or a known history of a hypercoagulable disorder
  • Active tuberculosis requiring treatment within 12 months prior to screening (Day -35).
  • Initiation of or change in allergen immunotherapy within 3 months prior to screening (Day -35) or during the run-in period.
  • Initiation of or change in aspirin desensitization within 4 months prior to screening (Day -35) or during the run-in period.
  • Pregnant or breastfeeding, or intending to become pregnant during the study or within 60 days after the last dose of omalizumab.
  • Current or history of malignancy within 5 years prior to screening, except for appropriately treated carcinoma in situ of the cervix or non-melanoma skin carcinoma that has been treated or excised and is considered resolved.
  • Any serious medical condition (including but not limited to significant arrhythmia, uncontrolled hypertension, significant pulmonary disease other than asthma) or abnormality in clinical laboratory tests that precludes the participant's safe participation in and completion of the study.
  • History of alcohol, drug, or chemical abuse within 6 months of screening.
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
127 participants (actual)

Study arms

  • Experimental
    Omalizumab

    Participants received omalizumab as a subcutaneous injection once every 2 weeks (q2w) or once every 4 weeks (q4w). The dose (from 75 mg up to 600 mg) and dosing frequency (q2w or q4w) was determined by serum total IgE level and body weight using the study-drug dosing table. All participants were also treated during the entire study with intranasal corticosteroids (mometasone nasal spray) as background therapy.

    Drug: Omalizumab

  • Placebo comparator
    Placebo

    Participants received matching placebo as a subcutaneous injection once every 2 weeks or once every 4 weeks. The dose and dosing frequency was determined by serum total IgE level and body weight using the study-drug dosing table. All participants were also treated during the entire study with intranasal corticosteroids (mometasone nasal spray) as background therapy.

    Drug: Placebo

Interventions

  • Participants received omalizumab as a subcutaneous injection once every 2 weeks (q2w) or once every 4 weeks (q4w). The dose (from 75 mg up to 600 mg) and dosing frequency (q2w or q4w) was determined by serum total IgE level and body weight using the study-drug dosing table.

    Also known as: Xolair, IGE025, RO5489789

  • DrugPlacebo

    Participants received matching placebo as a subcutaneous injection once every 2 weeks or once every 4 weeks. The dose and dosing frequency was determined by serum total IgE level and body weight using the study-drug dosing table.

06

What researchers measure

Primary outcomes

  1. Change From Baseline in Nasal Polyp Score (NPS) at Week 24

    Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

    Time frame: Baseline, Week 24

  2. Change From Baseline in Average Daily Nasal Congestion Score (NCS) at Week 24

    The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 24 (Study Days 155 to 186)

Secondary outcomes

  1. Change From Baseline in Average Daily Sense of Smell Score at Week 24

    The Sense of Smell Score was assessed daily by the participant via an electronic diary as the response to the following question: Is your sense of smell reduced? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 24 (Study Days 155 to 186)

  2. Change From Baseline in Average Daily Posterior Rhinorrhea Score at Week 24

    The Posterior Rhinorrhea Score was assessed daily by the participant via an electronic diary as the response to the following question: Do you feel dripping at the back of the nose? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0=Not at all; 1=Mild; 2=Moderate; and 3=Severe. For each study day, a score was calculated using an average of the prior 7 days among available days within a pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days, otherwise the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 24 (Study Days 155 to 186)

  3. Change From Baseline in Nasal Polyp Score (NPS) at Week 16

    Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

    Time frame: Baseline, Week 16

  4. Change From Baseline in Average Daily Nasal Congestion Score at Week 16

    The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options, scored from 0 (no symptoms) to 3 (severe symptoms) were: 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 16: Study Days 99 to 126), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 112), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 16 (Study Days 99 to 126)

  5. Change From Baseline in Participant Reported Health-Related Quality of Life (HRQoL) as Assessed by the Total Sino-Nasal Outcome Test (SNOT)-22 Questionnaire at Week 24

    The SNOT-22 Questionnaire, a disease specific HRQoL measure, comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant was asked to rate how severe each problem had been for them over the past 2 weeks on a scale from 0 (no problem at all) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating less disease and better HRQoL. A negative score indicates a decrease (or improvement) from the baseline score.

    Time frame: Baseline, Week 24

  6. Change From Baseline in Average Daily Anterior Rhinorrhea Score at Week 24

    The Anterior Rhinorrhea Score was assessed daily by the participant via an electronic diary as the response to the following question: Do you have a runny nose? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0=Not at all; 1=Mild; 2=Moderate; and 3=Severe. For each study day, a score was calculated using an average of the prior 7 days among available days within a pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days, otherwise the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 24 (Study Days 155 to 186)

  7. Number of Participants Requiring Rescue Medication (Systemic Corticosteroids for ≥3 Consecutive Days) Through Week 24

    A participant was considered to have had the event of requiring rescue medication if they had taken systemic corticosteroids for 3 or more consecutive days at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not taken systemic corticosteroids for 3 or more consecutive days, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

    Time frame: Up to Week 24

  8. Number of Participants Having Had Surgery for Nasal Polyps Through Week 24

    A participant was considered to have had the event of surgery for nasal polyps if they underwent the procedure at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not undergone surgery for nasal polyps, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

    Time frame: Up to Week 24

  9. Number of Participants With a Change From Baseline at Week 24 in Asthma Quality of Life Questionnaire (AQLQ) of ≥0.5 in Participants With Comorbid Asthma Only

    The AQLQ is a 32-item participant-reported measure of asthma-related quality of life (QoL) with a total score (the mean of all 32 responses) ranging from 1 (severely impaired) to 7 (not impaired at all); a higher score indicates a better QoL. An increase of at least 0.5 points in the AQLQ score was considered the minimal important difference for improvement in QoL.

    Time frame: Baseline and Week 24

  10. Number of Participants Requiring Rescue Treatment (Systemic Corticosteroids For ≥3 Consecutive Days or Having Had Surgery for Nasal Polyps) Through Week 24

    A participant was considered to have had the event of requiring rescue treatment if they had taken systemic corticosteroids for 3 or more consecutive days or had nasal polypectomy at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not received rescue treatment, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

    Time frame: Up to Week 24

  11. Number of Participants With Reduction in the Need for Surgery for Nasal Polyps by Week 24, as Defined by an NPS of ≤4 (Unilateral Score of ≤2 on Each Side) and Improvement in SNOT-22 Score of ≥8.9

    A participant was considered to have had the event of reduction in the need for surgery for nasal polyps if they had a Nasal Polyp Score (NPS) of ≤4 and an improvement in the SNOT-22 score of ≥8.9 (minimal important difference) without rescue treatment at Week 24; if the participant had received rescue treatment or had discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing, then they did not have the event. Participants without an intercurrent event and without valid Week 24 assessments of both NPS and SNOT-22 were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

    Time frame: Up to Week 24

  12. Change From Baseline in Average Daily Total Nasal Symptom Score (TNSS) at Week 24

    The Total Nasal Symptom Score (TNSS) was defined as the sum of the four individual scores for Nasal Congestion Score, Anterior Rhinorrhea Score, Posterior Rhinorrhea Score, and Sense of Smell Score, ranging from 0 (no symptoms) to 12 (most severe symptoms), assessed daily by the participant via an electronic diary. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

    Time frame: Baseline, Week 24 (Study Days 155 to 186)

  13. Change From Baseline in Sense of Smell, as Assessed by The University of Pennsylvania Smell Identification Test (UPSIT) Score at Week 24

    The UPSIT is a 40-question instrument that measures an individual's ability to detect odors and ranges from 0 to 40, with a higher score indicating a better sense of smell. It is a self-administered "scratch-and-sniff" test provided in booklets that have 40 microencapsulated odorants, each with a multiple-choice option for the response. The number of correct responses is summed to provide a total score.

    Time frame: Baseline, Week 24

  14. Number of Participants Who Experienced at Least One Adverse Event by Greatest Severity

    All adverse events (AE) were treatment emergent AEs, defined as any new AE or any worsening of an existing condition with an onset date on or after the first study drug administration date. AEs were assessed for severity according to the following grading scale: mild (discomfort noticed, but no disruption of normal daily activity), moderate (discomfort sufficient to reduce or affect normal daily activity), or severe (incapacitating with inability to work or to perform normal daily activity). The terms "severe" and "serious" are not synonymous; regardless of severity, some events may have also met seriousness criteria. Multiple occurrences of the same AE in one individual are counted once at the greatest intensity.

    Time frame: Up to Week 28

  15. Number of Participants Who Experienced at Least One Serious Adverse Event

    A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.

    Time frame: Up to Week 28

  16. Number of Participants With Adverse Events Leading to Omalizumab/Placebo Discontinuation

    Time frame: Up to Week 24

  17. Number of Participants With Laboratory Abnormalities by Highest Grade Post-Baseline

    Clinical laboratory tests for serum chemistry and hematology parameters were performed at laboratories; any abnormal values (High or Low) were based on laboratory normal ranges. Laboratory abnormalities are presented by the highest grade according to the World Health Organization (WHO) grade for Adverse Events, except for eosinophils and white blood cells that were graded according to the FDA Toxicity Grading Scale for Healthy Volunteers. Not every abnormal laboratory value qualified as an adverse event, only if it met any of the following criteria: clinically significant (per investigator); accompanied by clinical symptoms; resulted in a change in study treatment; or required a change in concomitant therapy. SGPT/ALT = serum glutamic-pyruvic transaminase/alanine aminotransferase; SGOT/AST = serum glutamic-oxaloacetic transaminase/aspartate aminotransferase

    Time frame: Up to Week 28

  18. Mean Serum Concentration of Omalizumab at Specified Timepoints

    Serum concentrations of omalizumab were quantified using an enzyme-linked immunoabsorbent assay (ELISA) with a lower limit of quantification (LLOQ) of 28.0 nanograms per millilitre (ng/mL). According to the analysis plan, values below the lower limit of quantification (BLQ) were set to 14 ng/mL (i.e. half of LLOQ value). If one-third or fewer of participants had results that were BLQ, then all summary statistics were to be calculated. However, if more than one-third of participants had results that were BLQ, then the mean and standard deviation were non-reportable and only the median and maximum were to be calculated for that timepoint.

    Time frame: Predose on Day 1, Week 16, Week 24, Unscheduled Visit (outside of planned study visits, as clinically indicated), Dosing Termination/Early Termination Visit (up to 28 weeks)

  19. Median Serum Concentration of Omalizumab at Specified Timepoints

    Serum concentrations of omalizumab were quantified using an enzyme-linked immunoabsorbent assay (ELISA) with a lower limit of quantification (LLOQ) of 28.0 nanograms per millilitre (ng/mL). According to the analysis plan, values below the lower limit of quantification (BLQ) were set to 14 ng/mL (i.e. half of LLOQ value). If one-third or fewer of participants had results that were BLQ, then all summary statistics were to be calculated. However, if more than one-third of participants had results that were BLQ, then the mean and standard deviation were non-reportable and only the median and maximum were to be calculated for that timepoint.

    Time frame: Predose on Day 1, Week 16, Week 24, Unscheduled Visit (outside of planned study visits, as clinically indicated), Dosing Termination/Early Termination Visit (up to 28 weeks)

  20. Mean Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints

    Serum concentrations of total immunoglobulin E (IgE) and free IgE were measured throughout the 24-week blinded treatment period, as target engagement biomarkers of omalizumab, using validated quantitative immunoassays with lower limits of quantification of 2 and 0.83 International Units per millilitre (IU/mL), respectively, and upper limits of quantification (ULQ) of 5000 and 62.5 IU/mL, respectively. The free IgE assay had limited range to measure circulating levels of free IgE in the presence of complexes of omalizumab-IgE. According to the analysis plan for the free IgE assay, results above ULQ were set to 62.5 IU/mL. If results for one-third or fewer of the participants were greater than the ULQ, then all summary statistics were to be reported. However, if the results for more than one-third of participants were greater than the ULQ, then only the median, interquartile range and minimum were calculated, and the mean, standard deviation, and maximum were non-reportable.

    Time frame: Predose on Day 1, Week 16, Week 24

  21. Median Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints

    Serum concentrations of total immunoglobulin E (IgE) and free IgE were measured throughout the 24-week blinded treatment period, as target engagement biomarkers of omalizumab, using validated quantitative immunoassays with lower limits of quantification of 2 and 0.83 International Units per millilitre (IU/mL), respectively, and upper limits of quantification (ULQ) of 5000 and 62.5 IU/mL, respectively. The free IgE assay had limited range to measure circulating levels of free IgE in the presence of complexes of omalizumab-IgE. According to the analysis plan for the free IgE assay, results above ULQ were set to 62.5 IU/mL. If results for one-third or fewer of the participants were greater than the ULQ, then all summary statistics were to be reported. However, if the results for more than one-third of participants were greater than the ULQ, then only the median, interquartile range and minimum were calculated, and the mean, standard deviation, and maximum were non-reportable.

    Time frame: Predose on Day 1, Week 16, Week 24

07

Results

Posted Mar 23, 2020

Participant flow

Participant flow — Overall Study
MilestonePlaceboOmalizumab
Started6562
Completed6358
Not completed24
Withdrew: Withdrawal by subject24

Outcome measures

PrimaryChange From Baseline in Nasal Polyp Score (NPS) at Week 24

Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

Time frame:
Baseline, Week 24
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Nasal Polyp Score (NPS) at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Nasal Polyp Score (NPS) at Week 24-0.31 (-0.63 to 0.01)-0.90 (-1.23 to -0.57)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0140 (Tested at the two-sided 0.05 significance level. There was no adjustment for multiplicity for the co-primary outcome measures.) · Difference in least squares means: -0.59 · 95% CI -1.05 to -0.12Difference in least squares means: Omalizumab arm minus Placebo arm.
PrimaryChange From Baseline in Average Daily Nasal Congestion Score (NCS) at Week 24

The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 24 (Study Days 155 to 186)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Nasal Congestion Score (NCS) at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Nasal Congestion Score (NCS) at Week 24-0.20 (-0.42 to 0.01)-0.70 (-0.92 to -0.48)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0017 (Tested at the two-sided 0.05 significance level. There was no adjustment for multiplicity for the co-primary outcome measures.) · Difference in least squares means: -0.50 · 95% CI -0.80 to -0.19Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Average Daily Sense of Smell Score at Week 24

The Sense of Smell Score was assessed daily by the participant via an electronic diary as the response to the following question: Is your sense of smell reduced? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 24 (Study Days 155 to 186)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Sense of Smell Score at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Sense of Smell Score at Week 24-0.13 (-0.33 to 0.06)-0.58 (-0.78 to -0.38)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0024 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -0.45 · 95% CI -0.73 to -0.16Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Average Daily Posterior Rhinorrhea Score at Week 24

The Posterior Rhinorrhea Score was assessed daily by the participant via an electronic diary as the response to the following question: Do you feel dripping at the back of the nose? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0=Not at all; 1=Mild; 2=Moderate; and 3=Severe. For each study day, a score was calculated using an average of the prior 7 days among available days within a pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days, otherwise the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 24 (Study Days 155 to 186)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Posterior Rhinorrhea Score at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Posterior Rhinorrhea Score at Week 24-0.00 (-0.19 to 0.18)-0.55 (-0.74 to -0.35)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0001 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -0.54 · 95% CI -0.81 to -0.27Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Nasal Polyp Score (NPS) at Week 16

Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

Time frame:
Baseline, Week 16
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Nasal Polyp Score (NPS) at Week 16
Score on a scalePlaceboOmalizumab
Change From Baseline in Nasal Polyp Score (NPS) at Week 16-0.29 (-0.61 to 0.04)-1.20 (-1.54 to -0.86)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0002 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -0.91 · 95% CI -1.39 to -0.44Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Average Daily Nasal Congestion Score at Week 16

The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options, scored from 0 (no symptoms) to 3 (severe symptoms) were: 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 16: Study Days 99 to 126), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 112), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 16 (Study Days 99 to 126)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Nasal Congestion Score at Week 16
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Nasal Congestion Score at Week 16-0.21 (-0.41 to -0.01)-0.80 (-1.00 to -0.59)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = <0.0001 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -0.59 · 95% CI -0.87 to -0.30Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Participant Reported Health-Related Quality of Life (HRQoL) as Assessed by the Total Sino-Nasal Outcome Test (SNOT)-22 Questionnaire at Week 24

The SNOT-22 Questionnaire, a disease specific HRQoL measure, comprises a list of 22 symptoms and social or emotional consequences of the nasal disorder. Every participant was asked to rate how severe each problem had been for them over the past 2 weeks on a scale from 0 (no problem at all) to 5 (problem as bad as it can be). The total score is the sum of the scores for all 22 items, ranging from 0 to 110, with a lower score indicating less disease and better HRQoL. A negative score indicates a decrease (or improvement) from the baseline score.

Time frame:
Baseline, Week 24
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Participant Reported Health-Related Quality of Life (HRQoL) as Assessed by the Total Sino-Nasal Outcome Test (SNOT)-22 Questionnaire at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Participant Reported Health-Related Quality of Life (HRQoL) as Assessed by the Total Sino-Nasal Outcome Test (SNOT)-22 Questionnaire at Week 24-6.55 (-10.88 to -2.23)-21.59 (-26.05 to -17.14)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = <0.0001 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -15.04 · 95% CI -21.26 to -8.82Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Average Daily Anterior Rhinorrhea Score at Week 24

The Anterior Rhinorrhea Score was assessed daily by the participant via an electronic diary as the response to the following question: Do you have a runny nose? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0=Not at all; 1=Mild; 2=Moderate; and 3=Severe. For each study day, a score was calculated using an average of the prior 7 days among available days within a pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days, otherwise the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 24 (Study Days 155 to 186)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Anterior Rhinorrhea Score at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Anterior Rhinorrhea Score at Week 24-0.08 (-0.27 to 0.11)-0.70 (-0.90 to -0.51)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = <0.0001 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -0.63 · 95% CI -0.90 to -0.35Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryNumber of Participants Requiring Rescue Medication (Systemic Corticosteroids for ≥3 Consecutive Days) Through Week 24

A participant was considered to have had the event of requiring rescue medication if they had taken systemic corticosteroids for 3 or more consecutive days at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not taken systemic corticosteroids for 3 or more consecutive days, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

Time frame:
Up to Week 24
Reported as:
Count of participants · Participants
Number of Participants Requiring Rescue Medication (Systemic Corticosteroids for ≥3 Consecutive Days) Through Week 24
ParticipantsPlaceboOmalizumab
Number of Participants Requiring Rescue Medication (Systemic Corticosteroids for ≥3 Consecutive Days) Through Week 2451
Statistical analysis
  • Placebo vs Omalizumab · Wald Chi-Square · p = 0.1594 (Tested at the two-sided 0.05 significance level.) · Odds ratio (or): 0.20 · 95% CI 0.02 to 1.89Odds ratio is comparing Omalizumab arm to Placebo arm.
SecondaryNumber of Participants Having Had Surgery for Nasal Polyps Through Week 24

A participant was considered to have had the event of surgery for nasal polyps if they underwent the procedure at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not undergone surgery for nasal polyps, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

Time frame:
Up to Week 24
Reported as:
Count of participants · Participants
Number of Participants Having Had Surgery for Nasal Polyps Through Week 24
ParticipantsPlaceboOmalizumab
Number of Participants Having Had Surgery for Nasal Polyps Through Week 2410
Statistical analysis
  • Placebo vs Omalizumab · Fisher Exact · p = 1.0000 (Tested at the two-sided 0.05 significance level.) · Odds ratio (or): 0.00 · 95% CI 0.00 to 20.61Odds ratio is comparing Omalizumab arm to Placebo arm.
SecondaryNumber of Participants With a Change From Baseline at Week 24 in Asthma Quality of Life Questionnaire (AQLQ) of ≥0.5 in Participants With Comorbid Asthma Only

The AQLQ is a 32-item participant-reported measure of asthma-related quality of life (QoL) with a total score (the mean of all 32 responses) ranging from 1 (severely impaired) to 7 (not impaired at all); a higher score indicates a better QoL. An increase of at least 0.5 points in the AQLQ score was considered the minimal important difference for improvement in QoL.

Time frame:
Baseline and Week 24
Reported as:
Count of participants · Participants
Number of Participants With a Change From Baseline at Week 24 in Asthma Quality of Life Questionnaire (AQLQ) of ≥0.5 in Participants With Comorbid Asthma Only
ParticipantsPlaceboOmalizumab
Number of Participants With a Change From Baseline at Week 24 in Asthma Quality of Life Questionnaire (AQLQ) of ≥0.5 in Participants With Comorbid Asthma Only1220
Statistical analysis
  • Placebo vs Omalizumab · Wald Chi-Square · p = 0.0396 · Odds ratio (or): 4.04 · 95% CI 1.07 to 15.25Odds ratio is comparing Omalizumab arm to Placebo arm.
SecondaryNumber of Participants Requiring Rescue Treatment (Systemic Corticosteroids For ≥3 Consecutive Days or Having Had Surgery for Nasal Polyps) Through Week 24

A participant was considered to have had the event of requiring rescue treatment if they had taken systemic corticosteroids for 3 or more consecutive days or had nasal polypectomy at any point between randomization and Week 24; if the participant had greater than 155 days of follow-up on study and had not received rescue treatment, then they did not have the event. Participants with less than 155 days of follow-up on the study were classified as having had the event if they discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing; if the participant had less than 155 days of follow-up on study and had not already met these criteria, they were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

Time frame:
Up to Week 24
Reported as:
Count of participants · Participants
Number of Participants Requiring Rescue Treatment (Systemic Corticosteroids For ≥3 Consecutive Days or Having Had Surgery for Nasal Polyps) Through Week 24
ParticipantsPlaceboOmalizumab
Number of Participants Requiring Rescue Treatment (Systemic Corticosteroids For ≥3 Consecutive Days or Having Had Surgery for Nasal Polyps) Through Week 2451
Statistical analysis
  • Placebo vs Omalizumab · Wald Chi-Square · p = 0.1594 (Tested at the two-sided 0.05 significance level.) · Odds ratio (or): 0.20 · 95% CI 0.02 to 1.89Odds ratio is comparing Omalizumab arm to Placebo arm.
SecondaryNumber of Participants With Reduction in the Need for Surgery for Nasal Polyps by Week 24, as Defined by an NPS of ≤4 (Unilateral Score of ≤2 on Each Side) and Improvement in SNOT-22 Score of ≥8.9

A participant was considered to have had the event of reduction in the need for surgery for nasal polyps if they had a Nasal Polyp Score (NPS) of ≤4 and an improvement in the SNOT-22 score of ≥8.9 (minimal important difference) without rescue treatment at Week 24; if the participant had received rescue treatment or had discontinued study drug due to adverse event, progressive disease, or lack of efficacy and remained missing, then they did not have the event. Participants without an intercurrent event and without valid Week 24 assessments of both NPS and SNOT-22 were classified as having a missing outcome. The null hypothesis was to be assessed by the Wald Chi-square test of the treatment term in the logistic regression model. If model convergence was an issue, then Fisher's Exact test was to be used.

Time frame:
Up to Week 24
Reported as:
Count of participants · Participants
Number of Participants With Reduction in the Need for Surgery for Nasal Polyps by Week 24, as Defined by an NPS of ≤4 (Unilateral Score of ≤2 on Each Side) and Improvement in SNOT-22 Score of ≥8.9
ParticipantsPlaceboOmalizumab
Number of Participants With Reduction in the Need for Surgery for Nasal Polyps by Week 24, as Defined by an NPS of ≤4 (Unilateral Score of ≤2 on Each Side) and Improvement in SNOT-22 Score of ≥8.9210
Statistical analysis
  • Placebo vs Omalizumab · Fisher Exact · p = 0.0139 (Tested at the two-sided 0.05 significance level.) · Odds ratio (or): 6.22 · 95% CI 1.23 to 60.23Odds ratio is comparing Omalizumab arm to Placebo arm.
SecondaryChange From Baseline in Average Daily Total Nasal Symptom Score (TNSS) at Week 24

The Total Nasal Symptom Score (TNSS) was defined as the sum of the four individual scores for Nasal Congestion Score, Anterior Rhinorrhea Score, Posterior Rhinorrhea Score, and Sense of Smell Score, ranging from 0 (no symptoms) to 12 (most severe symptoms), assessed daily by the participant via an electronic diary. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Time frame:
Baseline, Week 24 (Study Days 155 to 186)
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Average Daily Total Nasal Symptom Score (TNSS) at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Average Daily Total Nasal Symptom Score (TNSS) at Week 24-0.44 (-1.07 to 0.19)-2.53 (-3.18 to -1.89)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = <0.0001 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: -2.09 · 95% CI -3.00 to -1.18Difference in least squares means: Omalizumab arm minus Placebo arm.
SecondaryChange From Baseline in Sense of Smell, as Assessed by The University of Pennsylvania Smell Identification Test (UPSIT) Score at Week 24

The UPSIT is a 40-question instrument that measures an individual's ability to detect odors and ranges from 0 to 40, with a higher score indicating a better sense of smell. It is a self-administered "scratch-and-sniff" test provided in booklets that have 40 microencapsulated odorants, each with a multiple-choice option for the response. The number of correct responses is summed to provide a total score.

Time frame:
Baseline, Week 24
Reported as:
Least squares mean · Score on a scale
Change From Baseline in Sense of Smell, as Assessed by The University of Pennsylvania Smell Identification Test (UPSIT) Score at Week 24
Score on a scalePlaceboOmalizumab
Change From Baseline in Sense of Smell, as Assessed by The University of Pennsylvania Smell Identification Test (UPSIT) Score at Week 240.44 (-1.15 to 2.04)4.31 (2.66 to 5.95)
Statistical analysis
  • Placebo vs Omalizumab · Mixed-Effect Model of Repeated Measures · p = 0.0011 (Tested at the two-sided 0.05 significance level.) · Difference in least squares means: 3.86 · 95% CI 1.57 to 6.15Difference in least squares means: Omalizumab arm minus Placebo arm
SecondaryNumber of Participants Who Experienced at Least One Adverse Event by Greatest Severity

All adverse events (AE) were treatment emergent AEs, defined as any new AE or any worsening of an existing condition with an onset date on or after the first study drug administration date. AEs were assessed for severity according to the following grading scale: mild (discomfort noticed, but no disruption of normal daily activity), moderate (discomfort sufficient to reduce or affect normal daily activity), or severe (incapacitating with inability to work or to perform normal daily activity). The terms "severe" and "serious" are not synonymous; regardless of severity, some events may have also met seriousness criteria. Multiple occurrences of the same AE in one individual are counted once at the greatest intensity.

Time frame:
Up to Week 28
Reported as:
Count of participants · Participants
Number of Participants Who Experienced at Least One Adverse Event by Greatest Severity
ParticipantsPlaceboOmalizumab
AEs of Any Severity3532
Mild AEs1918
Moderate AEs1310
Severe AEs34
SecondaryNumber of Participants Who Experienced at Least One Serious Adverse Event

A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.

Time frame:
Up to Week 28
Reported as:
Count of participants · Participants
Number of Participants Who Experienced at Least One Serious Adverse Event
ParticipantsPlaceboOmalizumab
Number of Participants Who Experienced at Least One Serious Adverse Event13
SecondaryNumber of Participants With Adverse Events Leading to Omalizumab/Placebo Discontinuation
Time frame:
Up to Week 24
Reported as:
Count of participants · Participants
Number of Participants With Adverse Events Leading to Omalizumab/Placebo Discontinuation
ParticipantsPlaceboOmalizumab
Number of Participants With Adverse Events Leading to Omalizumab/Placebo Discontinuation00
SecondaryNumber of Participants With Laboratory Abnormalities by Highest Grade Post-Baseline

Clinical laboratory tests for serum chemistry and hematology parameters were performed at laboratories; any abnormal values (High or Low) were based on laboratory normal ranges. Laboratory abnormalities are presented by the highest grade according to the World Health Organization (WHO) grade for Adverse Events, except for eosinophils and white blood cells that were graded according to the FDA Toxicity Grading Scale for Healthy Volunteers. Not every abnormal laboratory value qualified as an adverse event, only if it met any of the following criteria: clinically significant (per investigator); accompanied by clinical symptoms; resulted in a change in study treatment; or required a change in concomitant therapy. SGPT/ALT = serum glutamic-pyruvic transaminase/alanine aminotransferase; SGOT/AST = serum glutamic-oxaloacetic transaminase/aspartate aminotransferase

Time frame:
Up to Week 28
Reported as:
Count of participants · Participants
Number of Participants With Laboratory Abnormalities by Highest Grade Post-Baseline
ParticipantsPlaceboOmalizumab
Alkaline Phosphatase - High, Any Grade (Gr.)00
SGPT/ALT - High, Any Gr.41
SGPT/ALT - High, Gr. 141
SGOT/AST - High, Any Gr.20
SGOT/AST - High, Gr. 120
Creatinine - High, Any Gr.00
Eosinophils, Absolute Count (Abs.) - High, Any Gr.178
Eosinophils, Abs. - High, Gr. 1178
Hemoglobin - Low, Any Gr.00
Hemoglobin - High, Any Gr.00
Neutrophils, Segmented (Abs.) - Low, Any Gr.22
Neutrophils, Segmented (Abs.) - Low, Gr. 122
Platelet - Low, Any Gr.00
Potassium - Low, Any Gr.00
Potassium - High, Any Gr.11
Potassium - High, Gr. 111
Sodium - Low, Any Gr.00
Sodium - High, Any Gr.22
Sodium - High, Gr. 122
Bilirubin - High, Any Gr.22
Bilirubin - High, Gr. 111
Bilirubin - High, Gr. 211
Total Leukocyte Count - Low, Any Gr.20
Total Leukocyte Count - Low, Gr. 120
Total Leukocyte Count - High, Any Gr.40
Total Leukocyte Count - High, Gr. 130
Total Leukocyte Count - High, Gr. 210
SecondaryMean Serum Concentration of Omalizumab at Specified Timepoints

Serum concentrations of omalizumab were quantified using an enzyme-linked immunoabsorbent assay (ELISA) with a lower limit of quantification (LLOQ) of 28.0 nanograms per millilitre (ng/mL). According to the analysis plan, values below the lower limit of quantification (BLQ) were set to 14 ng/mL (i.e. half of LLOQ value). If one-third or fewer of participants had results that were BLQ, then all summary statistics were to be calculated. However, if more than one-third of participants had results that were BLQ, then the mean and standard deviation were non-reportable and only the median and maximum were to be calculated for that timepoint.

Time frame:
Predose on Day 1, Week 16, Week 24, Unscheduled Visit (outside of planned study visits, as clinically indicated), Dosing Termination/Early Termination Visit (up to 28 weeks)
Reported as:
Mean · nanograms per millilitre (ng/mL)
Mean Serum Concentration of Omalizumab at Specified Timepoints
nanograms per millilitre (ng/mL)PlaceboOmalizumab
Day 1—NA ± NA
Week 16—33600 ± 25000
Week 24—36500 ± 27200
Unscheduled Visit—44600 ± 49700
Dosing Termination/Early Termination Visit—34800 ± 29600
SecondaryMedian Serum Concentration of Omalizumab at Specified Timepoints

Serum concentrations of omalizumab were quantified using an enzyme-linked immunoabsorbent assay (ELISA) with a lower limit of quantification (LLOQ) of 28.0 nanograms per millilitre (ng/mL). According to the analysis plan, values below the lower limit of quantification (BLQ) were set to 14 ng/mL (i.e. half of LLOQ value). If one-third or fewer of participants had results that were BLQ, then all summary statistics were to be calculated. However, if more than one-third of participants had results that were BLQ, then the mean and standard deviation were non-reportable and only the median and maximum were to be calculated for that timepoint.

Time frame:
Predose on Day 1, Week 16, Week 24, Unscheduled Visit (outside of planned study visits, as clinically indicated), Dosing Termination/Early Termination Visit (up to 28 weeks)
Reported as:
Median · nanograms per millilitre (ng/mL)
Median Serum Concentration of Omalizumab at Specified Timepoints
nanograms per millilitre (ng/mL)PlaceboOmalizumab
Day 1—0.00 (NA to 49.5)
Week 16—25000 (6820 to 133000)
Week 24—26300 (8930 to 130000)
Unscheduled Visit—44600 (9420 to 79700)
Dosing Termination/Early Termination Visit—34800 (13900 to 55700)
SecondaryMean Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints

Serum concentrations of total immunoglobulin E (IgE) and free IgE were measured throughout the 24-week blinded treatment period, as target engagement biomarkers of omalizumab, using validated quantitative immunoassays with lower limits of quantification of 2 and 0.83 International Units per millilitre (IU/mL), respectively, and upper limits of quantification (ULQ) of 5000 and 62.5 IU/mL, respectively. The free IgE assay had limited range to measure circulating levels of free IgE in the presence of complexes of omalizumab-IgE. According to the analysis plan for the free IgE assay, results above ULQ were set to 62.5 IU/mL. If results for one-third or fewer of the participants were greater than the ULQ, then all summary statistics were to be reported. However, if the results for more than one-third of participants were greater than the ULQ, then only the median, interquartile range and minimum were calculated, and the mean, standard deviation, and maximum were non-reportable.

Time frame:
Predose on Day 1, Week 16, Week 24
Reported as:
Mean · IU/mL
Mean Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints
IU/mLPlaceboOmalizumab
Total IgE - Day 1230 ± 235218 ± 220
Total IgE - Week 16215 ± 172695 ± 608
Total IgE - Week 24253 ± 319641 ± 559
Free IgE - Day 1NA ± NANA ± NA
Free IgE - Week 16NA ± NA11.7 ± 13.9
Free IgE - Week 24NA ± NA11.6 ± 13.3
SecondaryMedian Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints

Serum concentrations of total immunoglobulin E (IgE) and free IgE were measured throughout the 24-week blinded treatment period, as target engagement biomarkers of omalizumab, using validated quantitative immunoassays with lower limits of quantification of 2 and 0.83 International Units per millilitre (IU/mL), respectively, and upper limits of quantification (ULQ) of 5000 and 62.5 IU/mL, respectively. The free IgE assay had limited range to measure circulating levels of free IgE in the presence of complexes of omalizumab-IgE. According to the analysis plan for the free IgE assay, results above ULQ were set to 62.5 IU/mL. If results for one-third or fewer of the participants were greater than the ULQ, then all summary statistics were to be reported. However, if the results for more than one-third of participants were greater than the ULQ, then only the median, interquartile range and minimum were calculated, and the mean, standard deviation, and maximum were non-reportable.

Time frame:
Predose on Day 1, Week 16, Week 24
Reported as:
Median · IU/mL
Median Serum Concentration of Total and Free Immunoglobulin E (IgE) at Specified Timepoints
IU/mLPlaceboOmalizumab
Total IgE - Day 1147 (82.0 to 333)135 (80.0 to 277)
Total IgE - Week 16141 (83.0 to 320)437 (292 to 1030)
Total IgE - Week 24147 (74.0 to 315)440 (279 to 742)
Free IgE - Day 162.5 (29.9 to 62.5)62.5 (26.2 to 62.5)
Free IgE - Week 1659.6 (31.3 to 62.5)7.58 (4.71 to 11.9)
Free IgE - Week 2459.6 (17.7 to 62.5)7.65 (5.46 to 10.8)

Adverse events

Collected over From Baseline until end of safety follow-up (up to 28 weeks). Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Placebo0/64 (0%)1/64 (1.6%)20/64 (31.3%)
Omalizumab0/63 (0%)3/63 (4.8%)17/63 (27%)
Most frequent serious events
Most frequent serious events
EventPlaceboOmalizumab
Hand fractureInjury, poisoning and procedural complications0/641/63
Snake biteInjury, poisoning and procedural complications0/641/63
AsthmaRespiratory, thoracic and mediastinal disorders0/641/63
PneumoniaInfections and infestations1/640/63
Most frequent other events
Most frequent other events
EventPlaceboOmalizumab
NasopharyngitisInfections and infestations9/645/63
HeadacheNervous system disorders3/647/63
Injection site reactionGeneral disorders2/645/63
AsthmaRespiratory, thoracic and mediastinal disorders5/641/63
EpistaxisRespiratory, thoracic and mediastinal disorders1/644/63
Nasal polypsRespiratory, thoracic and mediastinal disorders4/641/63

Baseline characteristics

Age, Continuous
Age, Continuous(years)PlaceboOmalizumabTotal
Mean51.0 ± 12.049.0 ± 11.950.1 ± 11.9
Sex: Female, Male
Sex: Female, Male(Participants)PlaceboOmalizumabTotal
Female212344
Male443983
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PlaceboOmalizumabTotal
Hispanic or Latino358
Not Hispanic or Latino6156117
Unknown or Not Reported112
Race (NIH/OMB)
Race (NIH/OMB)(Participants)PlaceboOmalizumabTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American000
White6561126
More than one race000
Unknown or Not Reported011
Geographic Region of Enrollment
Geographic Region of Enrollment(Participants)PlaceboOmalizumabTotal
North America141226
ex-North America5150101
Participants with Asthma Comorbidity and Aspirin Sensitivity
Participants with Asthma Comorbidity and Aspirin Sensitivity(Participants)PlaceboOmalizumabTotal
Asthmatic and Aspirin Sensitive182139
Asthmatic and Not Aspirin Sensitive211738
Not Asthmatic262450
Average Daily Nasal Congestion Score at Baseline
Average Daily Nasal Congestion Score at Baseline(Score on a scale)PlaceboOmalizumabTotal
Mean2.3 ± 0.62.3 ± 0.72.3 ± 0.7
Nasal Polyp Score (NPS) at Baseline
Nasal Polyp Score (NPS) at Baseline(Score on a scale)PlaceboOmalizumabTotal
Mean6.1 ± 0.96.4 ± 0.96.3 ± 0.9

7 further baseline measures are reported on the registry.

08

Study locations

45 sites
  • Clinical Research Center of Alabama, LLC
    Birmingham, Alabama 35209, United States
  • Banner University of Arizona Medical Center
    Tucson, Arizona 85724, United States
  • Kaiser Permanente - Rancho Cordova Medical Offices
    Rancho Cordova, California 95762, United States
  • Bensch Clinical Research LLC
    Stockton, California 95207, United States
  • Colorado ENT & Allergy
    Colorado Springs, Colorado 80909, United States
  • Specialist Global Research
    Hialeah, Florida 33012, United States
  • University of South Florida
    Tampa, Florida 33613, United States
  • University of Kansas Medical Center
    Kansas City, Kansas 66160, United States
  • Chesapeake Clinical Research Inc - CRN
    Baltimore, Maryland 21236, United States
  • Institute for Asthma & Allergy
    Chevy Chase, Maryland 20815, United States
  • Brigham and Womens Hospital
    Boston, Massachusetts 02115, United States
  • University of Missouri, ENT and Allergy Center of Missouri
    Columbia, Missouri 65212, United States
  • Allergy Associates Research Center LLC - CRN
    Portland, Oregon 97202, United States
  • TTS Research
    Boerne, Texas 78006, United States
  • Allergy & Asthma Res Ctr PA
    San Antonio, Texas 78251, United States
  • Eastern Virginia Medical School
    Norfolk, Virginia 23507, United States
  • UZ Gent
    Gent, 9000, Belgium
  • UZ Leuven
    Leuven, 3000, Belgium
  • Terveystalo Tampere
    Tampere, 33100, Finland
  • Centre Hospitalier Universitaire de Bordeaux Hopital Pellegrin
    Bordeaux, 33076, France
  • Hopital de Hautepierre
    Strasbourg, 67091, France
  • Nouvel Hopital Civil; Pole de Pathologie Thoracique
    Strasbourg, 67091, France
  • Bajcsy-Zsilinszky Korhaz es Rendelointezet
    Budapest, 1106, Hungary
  • Szent Imre Egyetemi Oktatokorhaz
    Budapest, 1115, Hungary
  • Szent Janos Korhaz es Eszak-Budai Egyesitett Korhazak
    Budapest, 1122, Hungary
  • Pecsi Tudomanyegyetem Altalanos Orvostudomanyi Kar
    Pecs, 7602, Hungary
  • Unidad de Investigacion CIMA SC
    Chihuahua, 31205, Mexico
  • Synexus - Katowice
    Katowice, 40-040, Poland
  • Centrum Medyczne Wos i Piwowarczyk
    Krakow, 31-572, Poland
  • Centrum Alergologii Specjalistyczna Przychodnia Alergologiczna
    Lublin, 20-552, Poland
  • Synexus - Warsaw
    Warszawa, 01-192, Poland
  • Centrum Medyczne Biotamed
    Wieliczka, 32-020, Poland
  • EMC Instytut Medyczny S.A.
    Wrocław, 50-220, Poland
  • Central Clinical Hospital With Polyclinic of President Administration of RF
    Moscow, Moskovskaja Oblast 121356, Russian Federation
  • Medical Center Uromed
    Smolensk, Moskovskaja Oblast 214031, Russian Federation
  • LLC Kurator
    Sankt-peterburg, Sankt Petersburg 196240, Russian Federation
  • Hospital de Jerez
    Jerez De La Frontera, Cadiz 11407, Spain
  • CHUS - H. Clinico U. de Santiago; Servicio de Otorrinonaringologia
    Santiago de Compostela, Salamanca 15706, Spain
  • Hospital Universitario Virgen Macarena
    Seville, Sevilla 41071, Spain
  • Hospital Clinic de Barcelona
    Barcelona, 08036, Spain
  • Hospital Universitario Fundacion Jimenez Diaz.
    Madrid, 28040, Spain
  • Hospital Universitari i Politecnic La Fe de Valencia
    Valencia, 46026, Spain
  • SI Institute of Otolaryngology n.a. Prof. O.S. Kolomiychenko
    Kyiv, KIEV Governorate 03680, Ukraine
  • Ternopil Municipal City Hospital
    Ternopil, Podolia Governorate 46000, Ukraine
  • Municipal Institution "City Clinical Hospital #3"
    Zaporizhzhia, Polissya Okruha 69032, Ukraine
09

References and documents

Publications

  • Damask C, Chen M, Holweg CTJ, Yoo B, Millette LA, Franzese C. Defining the Efficacy of Omalizumab in Nasal Polyposis: A POLYP 1 and POLYP 2 Subgroup Analysis. Am J Rhinol Allergy. 2022 Jan;36(1):135-141. doi: 10.1177/19458924211030486. Epub 2021 Aug 12. PubMed 34382434 ↗
  • Chong LY, Piromchai P, Sharp S, Snidvongs K, Webster KE, Philpott C, Hopkins C, Burton MJ. Biologics for chronic rhinosinusitis. Cochrane Database Syst Rev. 2021 Mar 12;3(3):CD013513. doi: 10.1002/14651858.CD013513.pub3. PubMed 33710614 ↗
  • Peters AT, Han JK, Hellings P, Heffler E, Gevaert P, Bachert C, Xu Y, Chuang CC, Neupane B, Msihid J, Mannent LP, Guyot P, Kamat S. Indirect Treatment Comparison of Biologics in Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2021 Jun;9(6):2461-2471.e5. doi: 10.1016/j.jaip.2021.01.031. Epub 2021 Feb 4. PubMed 33548517 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Nov 2017 to primary completion in Mar 2019, 15 months.

Results were first posted in Mar 2020, 1 year after primary completion.

Of 30 industry-sponsored phase 3 interventional studies under Nasal Polyps, half reached primary completion within 22 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 26. This study's 15 months is below that.

Counting every sponsor, half of 34 studies reached it within 22 months; a quarter within 19 and three quarters within 27.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 11, 2017
First posted
Sep 12, 2017
StartActual
Nov 21, 2017
Primary completionActual
Mar 7, 2019
CompletionActual
Mar 7, 2019
Results first posted
Mar 23, 2020
Last update
Mar 23, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 23, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03280537
Lead sponsor
Hoffmann-La Roche
Responsible party
Sponsor
First posted
Sep 12, 2017
Start date
Nov 21, 2017
Primary completion
Mar 7, 2019
Completion
Mar 7, 2019
Results posted
Mar 23, 2020
Last update
Mar 23, 2020

Study contacts

Clinical Trials
study director · Hoffmann-La Roche

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Omalizumab

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